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General NPI Number Information
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NPI Number | 1376870303
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Entity Type | Organization
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Legal Business Name | DAS S GURUJAL M.D LTD
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Dates
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Enumeration Date | 11/12/2009
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Last Update Date | 11/12/2009
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Provider Practice Location Address
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Address Line | 207 S PINE ST
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City | SHELBYVILLE
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State | IL
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Zip | 62565-1749
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Country | US
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Telephone | 217-774-5589
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Fax | 217-774-5733
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Provider Business Mailing Address
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Address Line | 207 S PINE ST
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City | SHELBYVILLE
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State | IL
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Zip | 62565-1749
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Country | US
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Telephone | 217-774-5589
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Fax | 217-774-5733
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Authorized Official
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Title or Position | PHYSICIAN
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Name | DR. DAS S GURUJAL
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Credential | M.D
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Telephone | 217-774-5589
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 036046622
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License Number State | IL
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